Candidate. My career goal is to reduce cancer health disparities in cancer survivorship by addressingsleep disturbance and other quality of life issues (e.g., distress, cognitive impairment, fear of cancerrecurrence) in minority cancer populations. I received a solid foundation in observational cancer quality oflife research, but my training has not provided the skills I need to develop mHealth behavioral interventionsor the skills needed to reduce cancer health disparities. I look forward to taking the next steps in mycareer development, and the K01 provides an ideal opportunity to develop the necessary skills to achievemy career goal. This line of research has the potential to significantly improve cancer survivorshipbecause of A) the large impact that sleep disturbance and other quality of life issues have on well-being,B) growing evidence of disparities in cancer survivorship, and C) the large and growing population ofminority cancer survivors.Career Development Plan. My career development plan builds on my training in observational cancerquality of life research. I propose to develop the skills necessary to become a leader in the field ofdeveloping mHealth behavioral interventions for sleep disturbance and other quality of life issues inminority cancer survivors. Training will be obtained through participation in scientific conferences(mHealth, sleep medicine, behavioral medicine), methods workshops (designing mHealth interventions,health disparities research, clinical trial analyses), coursework (health disparities, qualitative methods,mobile app development), and structured mentorship from experts in intervention development (Dr.Sharon Manne), cancer health disparities (Dr. Elisa Bandera), sleep disturbance (Dr. Martica Hall),qualitative interviewing (Dr. Shawna Hudson), mHealth methodology (Dr. Lee Ritterband), developingculturally targeted interventions (Dr. Cathy Meade), and grant writing. This training will ensure that Iachieve my goals, which are to: 1) Learn the health disparities research skills that will help meconceptualize and implement culturally targeted behavioral interventions for sleep disturbance and otherquality of life issues, 2) acquire the skills necessary to develop and test behavioral interventions, includingqualitative interviewing, mHealth methodology, and clinical trial analyses, and 3) Develop a deeperunderstanding of sleep disturbance and other quality of life issues in cancer survivors.Research Plan. We propose a sequential mixed methods approach to develop and pilot test a newmHealth behavioral intervention for cancer-related sleep disturbance that is culturally targeted toAfrican American breast cancer survivors. We plan to take a holistic approach to cancer-related sleepdisturbance as compared to standard treatment for primary insomnia, which is less effective in cancersurvivors than in the general population. We will first identify predictors of cancer-related sleep disturbancein a unique cohort of African American breast cancer survivors as well as collect qualitative data on thebarriers to standard treatment and opportunities for cultural targeting (Aim 1). Using data gathered in Aim1, we will iteratively develop an mHealth intervention to address cancer-related sleep disturbance inAfrican American breast cancer survivors (Aim 2). This intervention will address predictors of cancer-related sleep disturbance, reduce barriers to motivation and usage, and be culturally targeted to thispopulation. It will also be tailored to patients' unique sleep patterns, adjusting recommendations basedon automatically gathered objective sleep data via actigraphs (unobtrusive wrist-worn devices). Lastly, wewill test this intervention for acceptability, feasibility, and preliminary efficacy (Aim 3). Thus, this projectwill address a health disparity for a distressing quality of life issue in a large and growing population.Mentorship Team. Each member of the mentorship team has external funding, including eight R01sbetween the five mentors. The team has excellent publication and mentorship track records.Collaborations with this esteemed mentorship team will result in 3-4 publications per year (2-3 first-authored).Environmental and Institutional Commitment. The research environment, facilities, and resources atthe Rutgers Cancer Institute of New Jersey are ideal for career development in cancer survivorshipdisparities research. Numerous training opportunities are available across campus. I will carry out my K01activities as a tenure-track Assistant Professor in the Division of Population Science with stronginstitutional commitment, including from Associate Director for Population Science Dr. Sharon Manne.Conclusions. Cancer-related sleep disturbance is a common and distressing survivorship issue. AfricanAmerican breast cancer survivors are at urgent need for a culturally targeted intervention that addressesthe factors that make cancer-related sleep disturbance different from primary insomnia. In the proposedsequential mixed methods study, I will develop a new, tailored, mHealth, and culturally targetedintervention for cancer-related sleep disturbance in African American breast cancer survivors. The useof mHealth methods will ensure wide disseminability. The K01 award period will culminate in a R01proposal. The K01 mentored career development award will support my transition to independenceand position me as an expert in reducing cancer health disparities in cancer survivorship.
Cancer-related sleep disturbance is a common and distressing issue affecting breast cancer survivors;especially African American breast cancer survivors. To reduce this cancer health disparity and to improve onexisting standard treatment; a new mHealth; culturally targeted; and tailored intervention will address riskfactors for cancer-related sleep disturbance and barriers to treatment that are unique to African Americanbreast cancer survivors. Given the high rates of mobile device ownership among older adults and the commonreliance of mobile devices for health information among African Americans; this intervention shows greatpromise for reducing cancer-related sleep disturbance and thereby improving survivorship among AfricanAmerican breast cancer survivors.
